Role of Cell Block Preparation in Cytopathological Diagnosis

ABSTRACT

Introduction: Though Fine needle Aspiration Cytology(FNAC) is good method for diagnosis of lesions, sometimes itdoes not provide precise diagnosis due to inadequate material.Present study was based on use of residual FNAC materialto make cell block in order to find out utility of cell blockpreparation of FNAC.Material and Methods: The two years prospective studycarried out in a tertiary Heath care hospital of central India,included 360 patients referred for FNAC of the lesions fromall body sites. After making the conventional FNAC smears,the remaining material in the needle hub and syringe wasobtained by flushing it with 10% alcohol –formalin. Aftercentrifugation the supernatant was decanted and depositfixed in freshly prepared 10% alcohol-formalin. After halfan hour alcohol-formalin was drained, cell button was takenon whatman-filter paper and processed as surgical tissue inautomated tissue processing machine. FNAC smears andcell block sections were examined separately for cellularity,reporting done and results correlated with histopathology.Results: Of 360 cases FNAC smears and cell blockswere adequate in 324(90%) and 313(86.94%) casesrespectively. Statastical analysis was done in 98 cases inwhich histopathology available. Sensitivity of FNAC was88.06%,specificity of 92.86% and accuracy of 89.47%.Sensitivity of cell block was 90.91%, specificity of 92.86%and accuracy of 91.47%. Sensitivity of combined FNAC andcell block technique was increased to 98.53% with specificityof 93.33% and accuracy of 96.94%.Conclusion: Cell blocks as an adjuvant to FNAC smears isvery effective technique in cytology to reach the definitivediagnosis.